Dr. Stephen D Sudderth, MD
Surgery in Vicksburg, MS. Individual provider (NPI-1).
NPI number1528096849
StatusActive
Last updated in NPPESFeb 21, 2014
Details
- NPI
- 1528096849
- Entity type
- Individual (NPI-1)
- Name
- Dr. Stephen D Sudderth
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 28, 2006
- Last updated
- Feb 21, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - GENERAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 17597 | MS | Yes |
Practice location
188 Ymca PlVicksburg, MS 39183-3536
Phone 601-636-7222 · Fax 601-636-0440
Mailing address
188 Ymca PlVicksburg, MS 39183-3536
Phone 601-636-7222 · Fax 601-636-0440
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Surgery Physician providers in Vicksburg, MS
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- Hendrik K Kuiper MD INCNPI 1780882316
- Henry M Jarmon, MDNPI 1326074477
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All 6 Surgery Physician providers in Vicksburg · All 1,002 providers in Vicksburg
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